Boys can get anorexia too

By Laura Catalano, 21st Century Media

Friday, February 28, 2014

When Zachary Haines set out to lose weight during his sophomore year of high school, his family encouraged him.

After all, the 5-foot-7 Douglassville teen was considered obese, weighing in at 230 pounds. So, he began watching what he ate and exercising daily. When he dropped 45 pounds, family and friends were thrilled.

Then, for Christmas, Zachary asked for a gym membership. His mother happily obliged. Soon after, though, she grew concerned. Her son had begun spending three hours a day in the gym, and hardly eating enough to sustain such an active lifestyle.

Commonly, the then Daniel Boone Area High School student would eat only an apple for breakfast, head off to school where he would eat a light lunch, then arrive home, change and go to the gym. On his way home from his daily three-hour workouts, he was so hungry he would call home to make sure dinner was waiting for him when he returned. Even then, he would restrict his meal to specific, low calorie foods like a chicken breast with a sweet potato and vegetables.

“It was not enough to sustain him,” said Tarantola.

But Zachary felt empowered by his ability to lose and maintain his weight, and when his mother suggested he eat more, he strenuously disagreed.

“I would tell my mother ‘You’re always trying to lose weight, but you don’t know how.’ In my mind, what I was doing was always right,” Zachary said.

Nevertheless, Tarantola knew something was wrong with her son’s behavior. But it would be months before she could convince him to see a doctor. Then, it took another five months and visits to seven different medical professionals before Zachary finally had a diagnosis.

It turned out he was suffering from Anorexia Nervosa. By the time he was diagnosed in March of his senior year, his heart rate and blood pressure were so low that the nutritionist who examined him sent him immediately to Children’s Hospital of Philadelphia.

He remained there on an intensive re-feeding program for three-and-a-half weeks. During that time, his vitals were monitored constantly. At night while he slept his heart rate dipped down to 26 beats per minute.

“If it had gone down one more point, he would have been put in the intensive care unit,” said Tarantola.

Now a freshman at Temple University, Zachary is grateful for the steady recovery he has made since last March. But both he and his mother are left asking a lot of questions.

Missing the Signs

“The big problem I have is with the medical community not understanding Zach’s symptoms and not being able to identify this,” said Tarantola. “I’m shocked and appalled that specialists didn’t put this together.”

In fact, if Tarantola hadn’t been so persistent, it’s likely that her son wouldn’t have been diagnosed until things had gone too far.

“His vitals were so low, the doctors said eventually he would have collapsed,” she said.

Exactly how and why did so many doctors miss the tell-tale signs of an eating disorder in Zach? The answer isn’t that simple. For one thing, his weight didn’t set off any alarm bells. At 130 pounds on his 5-foot-7 frame, Zach was thin, but considered normal according to body mass index charts.

“He looked emaciated, but he fell into the low end of normal on the charts. As a child, Zachary was always in the 90th or 100th percentile for weight in his age group. And his father, who passed away in 2009, had a football player’s stature. Zachary was built like that, too. So, even though he was in the normal range for the charts, it wasn’t normal for him,” explained his mother.

What’s more, many of the doctors who examined Zachary felt his decision to eat only certain foods, like fruit, vegetables, yogurt and chicken, was a sign of healthy behavior. Likewise, they perceived his weight loss as a positive, in light of his former obese state.

And because he was so muscular, he didn’t appear emaciated to them.

“They never saw him before. They didn’t know what emaciated was for him,” said Tarantola.

Nevertheless, Zachary did have some classic signs of anorexia. During his senior year, he grew cold and shaky after eating, and suffered intense stomach pains. He later discovered those symptoms were caused by his body pulling all the energy from his extremities to aid in the digestion process.

Other symptoms included brown patches on his neck from malnutrition, elevated liver enzymes, very low testosterone, an underactive thyroid and a waking pulse of 40 (60 to 100 is normal).

Tarantola took Zachary first to his primary care doctor, then paraded him into the offices of a nutritionist, two liver specialists, two endocrinologists and a gastroenterologist.

“I said to the doctors ‘It’s because he’s not eating enough and he’s exercising too much,’” Tarantola recalled.

But none of them suspected an eating disorder until finally a doctor at CHOP recommended he see another nutritionist. Once again Tarantola found herself explaining Zachary’s symptoms, but by now, she was pleading for help. This time, after months of appointments and tests with no diagnosis, she finally got an answer.

“The nutritionist checked his vitals and sent him to the hospital right away,” said Tarantola.

The Importance of Persistence

Tarantola has made it her mission to make sure that other parents and teens are aware of the signs of anorexia in boys.

“I want people to know that it happens in boys,” she said.

But beyond that, she stressed the importance of being persistent, even when doctors are saying things are fine.

“I knew something was wrong and I wasn’t going to let any doctor talk me out of it,” she said.

Her perseverance is what ultimately led to Zachary’s diagnosis and recovery. But it wasn’t easy. She pointed out that she had good insurance, an understanding employer who allowed her to take off for doctors’ appointments, and a caring family.

“We had everything going for us and it was still so difficult,” she said.

Once Zachary was diagnosed, he proved a perfect patient. In the hospital, he ate a steadily increasing diet that eventually got up to 6,400 calories per day. And while he admits “I was scared of gaining weight,” he was happy to finally have a diagnosis and begin working on his recovery.

“I was almost waiting for someone to stop me from doing what I was doing,” he said. “I spent two-and-a-half years never eating pizza or ice cream. I was actually almost relieved when I was diagnosed.”

These days, Zachary continues to visit his doctor regularly at the CHOP adolescent behavior center in Philadelphia, where he is weighed twice a month to make sure he isn’t losing weight. He also had to give up his original plan to attend Slippery Rock University to become an athletic trainer after his doctors told him “You don’t want your whole career focus to be on athletics.”

“That was the best piece of advice I’d ever gotten,” Zachary now says.

He is now enrolled as a full-time student in the advertising program, on the art direction track at Temple University where “I love all my classes,” he said.

Like his mother, Zachary is determined to try to get the word out about males with anorexia.

“Parents need to be on the lookout for this, because if they know what to look for, they can catch it before it even starts,” he said.